Post-op Info, Plans, up-coming Shunt revisions

Talked to Dr.Bragg this morning, and just said to her how surprised I was by how uncomfortable/how much discomfort there has been since this shunt revision yesterday (Fri), the discomfort is just WOW! She said she wasn't to surprised unfortunately as really this surgery was more in-depth and more manipulating than is a normal, typical shunt revision.
She must have talked to my Cardiology Team as she said they do not recommend the Lovenox injections as a bridge between now and surgery the 14th. Instead they recommended to her I re-start Coumadin today and check-in with them on Monday (I suppose to say when I should next do INR Labs). Due to how high the INR blood level was when I came in they also recommended to her to start back on 5mgs/7 days a week vs 6mgs/7 days a week.
The plan was to release me today, while the head incision is just something incredibly uncomfortable I also am not doing anything else special here so no sense really to stay. I am not sure now though if I will get discharged today or now will it be tomorrow as I am on the PCA Pain pump since surgery and typically the docs like to wean this for 24 hrs before releasing pts. I am not entirely sure what is going on on that front yet.

Regarding Fup as Dr.Bragg goes on vacation sometime this week (I think it is, then comes back the day before my surgery) she wants to keep the Telfa dressing stapled over the surgical site until late next week. I'll fup with one of her NP's then on Thurs or Fri, they will check the site and remove the dressing.
Regarding the upcoming VP and Thoracic Shunt revisions Jan 14th, Dr.Bragg said she would want to admit me the day before again in order to check INR levels, any other Labs and she wants a CT scan to be done in which she uses this 'mapping' to load on to their Stealth Guidance machine in the OR. This machine is then used to help better visualize the small areas she works in and better position the VP shunt especially since she will be going back in to a area she previously had placed a shunt and which we had a lot of placement issues with at the time.

As far as the VP shunt she will use the same type of valve (Codman Hakim) as we've had good results with this minus the catheter wearing down the skin. In the case of the exposed catheter she feels this has to do w the Hakim valve, the skin that grew under the exposed catheter (a phenomenon she said she hadn't seen before) and the tip of the valve originally rubbing against the skin over time wearing it down. The skin that then began to grow under the catheter caused the tip of the valve or catheter (can't remember this part for certain) to be pushed up and in time wear down the skin creating the exposure. This took place over about a 9mo time as that valve was placed last March I believe.
Regarding the Thoracic Shunt she is thinking of using a newer valve her partner has had success with called a 'ProSA' programmable Valve. This is a smaller profile valve that she plans to (I think I remember this right) replace in the same location as the current Hakim Valve but she feels this will be a lot less noticeable with movement or sitting back and thus less uncomfortable. Dr.Bragg did say with this valve it is more of a pain to re-program as it does also require Xray to re-program after imaging (for instance MRI) and she said the re-programmer is different than anything else she has used. When they go to re-program the valve she said it is similar to clicking a pen, the tip has to touch the middle of the programmable valve in-order for proper re-programming to occur. Interesting!?! I just hope this valve works atleast as well if not even better than the Codman Hakim did!
For now I am on 2 IV antibiotics in-patient and will likely go home on the oral versions of these, the one i'll stay on right up till surgery.

One thing i'll have to ask about is if the NP's/Dr.Bragg can work with either my CHW Genetic Counselor or more likely my Genzyme Case Management Team in order to have the Aldurazyme shipped to UWHC that I would otherwise, normally get infused on 1/13 (the day before surgery).

I'll update again when I know something worth updating about,
Thanks for stopping by!

Erica

ProSa Valve

#28 Today's VP Shunt Surgery

This morning Lab-INR was a little high (not sure if it was higher than yesterday's) but the Neuro Team opted to do 2 Plasma bags over a quicker period (1-2 hours verses 4 or more hour infusion) in order to try and bring INR down to a more appropriate-less bleeding risk range for surgery.
The plan is to cover the open incision via (per the Resident) loosening the skin around the open VP shunt site/exposed shunt catheter and try to pull this over and I assume stitch that in place? Sounds a little on the gruesome (skin an indian anyone?) side.. Hopefully the Neurosurgery Team wont need to shave much hair/this loosening the skin wont affect hair growth... I know that's a vane thing to be concerned about but when you have so little control over many things related to your body it is nice to have a few things you can still manage!...

10:00PM 12/26-
So surgery was successful from what I glean from my Dad (talked to Dr.Bragg post-surgery) and the Nurses/Anesthesiologist who all updated me and in the case of Anesthesia stopped by my rm in post-op care. I'll update when I talk to Dr.Bragg in the morning though one thing the Staff and my Dad told me was Dr.Bragg was surprised by and had never seen where an exposed shunt catheter when they go to remove it has skin growing under the catheter (vs over I guess which would keep the area closed). I think they all said Dr.Bragg felt this might have something to do w the underlying MPS but I don't remember that part for certain and will ask tomorrow.
What I do know from Dr.Bragg as she stopped by my in-patient room late Friday morning after her other surgeries where done is that 1. she planned to use the previous VP shunt incision along the valve site (several inches long) and then take the exposed catheter and "under-mine" it by lifting and stretching skin (not sure if I re-explained that correctly), tuck the catheter inside what I think she explained (but again cant remember for certain) a pocket of sorts and then pull the 2 incision sides together and stitch it up. The incision is covered by a fairly large, stapled on Telfa sponge so I cant tell how big the area is.. It does look like they shaved a minority of surrounding hair which is/will be/would be great!
She plans to as I've written here before con't to treat the formerly exposed areas with antibiotics and Jan 14th we'll go back to the OR. Right now she (Dr.Bragg) is considering whether to bridge this next 2 1/2 (ish) weeks with injection Lovenox (is done twice daily) which offers fairly consistent INR level as the med only lasts 12 hrs. Otherwise she will restart the Coumadin, we'll have to con't daily blood draws until INR is back in-range and till I could be discharged.. Per the Cardiology NP getting INR back in-range can be more difficult when Vit K or Plasma has to be given to bring down a pre-surgery, high INR # though I cant remember why she said that was.

When Dr.Bragg does move the VP shunt valve and proximal catheter the 14th she plans to use the same shunt catheter tract (not sure if that's the right word to use) as the areas where the catheter feeds down to my abdomen/'T' connector have worked well and not a lot of options where else we could try. The valve will be at the back of my head again I guess (circa Dec/Jan 2012/'13 when we had bc of the shunt infections moved the VP shunt to a parietal location. I'll update on that down the road.. She plans to use the same Codman Hakim programmable valve (has worked pretty well, not perfectly but when the 2 shunts where working pretty well I did feel a lot better than I otherwise had in a long time! =)

I don't really know much else so will update when I do,
Thanks for stopping by!
Erica

Surgery; Exposed (VP) Shunt site

I was re-admitted to the Neurosurgery floor today (Thurs) in-order that Labs (specifically/especially INR which was just a tad high at 1.8 per the Nurse), Chest Xray, Urine culture and Exam. Otherwise I have just been wandering the hospital some early this afternoon (had to check-in at 1:00) and then hanging in my room. A good friend of mine came to visit tonight for several hours which was lovely. One of her kiddos also has a shunt and complex shunt issues so she completely gets all this

Surgery is scheduled at 12:30/12:50 (somewhere in there) tomorrow under General Anesthetic to cover the exposed VP shunt catheter site. The exposed site is located right next to the programmable valve which Dr.Bragg said last weekend is usually a little more difficult of an area to close. I don't know actual details of what she will do yet but she still plans to cover this open area, followed by continuing treating with antibiotics and in several weeks (Jan 14th) move the VP shunt location although I don't know if that means just moving the distal location or if she plans to move the entire shunt to a different site? Either way the surgery is 2-part in a sense, several weeks apart.

I know this is short but thanks for stopping by, prayers appreciated!
I'll update when I get a chance,
Erica

Merry Christmas! (released, re-admit Thurs for Friday surgery)

Merry Christmas!!
Sorry for no update regarding what is going on with the exposed (VP) shunt catheter. See below for the details regarding getting released this past Sunday but Dr.Bragg had decided I could go home on Sunday instead of Monday and she would bring me back on Thurs and then surgery is still Fri. I have to be back at UW at 1:00 on Thurs to be re-admitted to the Neurosurgery floor and then they will likely do labs to check INR (blood thinner level) and any other testing needed pre-surgery. The actual surgery Fri atleast as last planned was to be under General Anesthetic (meaning intubation).
Dr.Bragg wasn't yet sure on Sunday when I talked to her what she was going to do to temporarily cover the exposed catheter so I don't know those details, she often thinks over these surgeries right up till surgery in order to come up w a best plan. I am hopeful since I will have to go back in again Jan 14th for the actual surgery to move this shunt location that I will be able to get INR up fairly easily (post-surgery) and get out maybe as soon as Monday? I honestly don't know what she is thinking... This surgery was just a temporary cover in a sense so that the catheter isn't continue to be exposed to the outside and thus germs have an easy entrance site.. At the same time she said if she where to move the shunt right away in this surgery from their experience there has been a higher long term infection risk.. thus why she is doing this in 2 parts.

I have just been glad to have been home for a few days though I have to admit I felt more than a bit frazzled everyday since in trying to get the things done I needed to! Monday included Labs, ERT at CHW, pack everything for my parents today (we celebrate Christmas present opening Christmas Eve morning), My sister, Mom, nephews and I also decorated Cookies Monday night at my parents. Then when I finally got home in addition to packing up the presents I cleaned my Apt some (seems like tree needles EVERYWHERE!). Today after getting home from celebrating Christmas Eve morning/early afternoon at my parents and then later running errands (picking up meds, store, etc) I did some packing for Thurs re-admit, took down my tree and a bunch of other inconsequential things but that I needed to take care of! It didn't help that I forgot my planner and paperwork at home Monday that I wanted to do at ERT so I was working on that stuff in-between the past few days too!

Tonight I was able to go to my Church's Kids program (parochial school PreK-8 grade) which was lovely and so nice to be there in person versus watching a Christmas Eve service on TV like last year!


Written Sunday Dec 22 Alright so the now new plan is (found out mid-Sunday afternoon) that I get to be released Sunday evening on oral Clindamycin (antibiotic) instead of IV Clindamycin and a day earlier than they had planned due to there being the oral version of this antibiotic available. This in turn means I will go to ERT at CHW (Children's Hosp.) Monday morning per normal schedule vs being infused at UW, in-patient. Since my INR had continued to increase despite no increase in the Coumadin dose Dr.Bragg and the Pharmacist wrote an prescription for the injection Lovenox but don't expect i'll actually need to use it. I have to do a INR blood-lab test Monday while at CHW. Instead of admitting me the morning of surgery as formerly planned Dr.Bragg is also now planning with her team to direct admit me to the Neurosurgery floor Thurs. at which time they will do Lab draws to re-check INR. If this level is still to high they can then give a med to counteract the blood thinner and which makes the blood at a more surgery appropriate blood (clotting) level.

I'll update sometime Thurs with any details I learn regarding Fri's surgery.
If you believe in prayer, please pray that 1. surgery goes well and easy. and 2. That I get released from the hospital before Dr.Bragg goes on vacation (not sure when that is)!!!
A Prince was born to save OUR sins!
Erica

Talked to Dr.Bragg, Home for Christmas, A (tentative) Plan

This is copied from my latest fb update, a couple friends where asking for updates so I posted this there and copied it to here verses re-writing a completely new, but virtually the same post.
So the news is.... drumroll please (lol!)...
Per Dr.Bragg, Her plan is to let me out on Monday and have me come back on Fri. Part of the reasoning for waiting till Mon to get released is we wait for the INR (blood thinner level) to come down to a therapeutic (surgery appropriate?) level.. then bridge w injection Lovenox till Fri. They also are watching the CSF culture, have to arrange the various things and want to make a temporary cover of sorts for the open shunt (catheter) area.
I'll as of right now probably get out Monday for Tues-Thurs w/IV Antibiotics and the Lovenox injections (to bridge) and Neurosurgery will cover the open area over the shunt valve. Dr.Bragg said this is a harder area to go in and cover in surgery as it is right over/next to the valve so she is formulating the best initial treatment plan for when I go home and especially for surgery on Fri.
I'll come back on Fri for surgery (general anesthesia) to cover the open catheter via graft or some other method and then in a few more wks of IV Antibiotics likely after which I will come back on our already scheduled OR (surgery) date Jan. 14th to completely move the VP shunt. We'll put off the Thoracic shunt move to a future, to be determined date. Ironic since that is the shunt that most bothers me! I know we need to prevent any infections from occurring in this open VP shunt site though. =/

So that folks is how 1 surgery in Jan. now becomes 3 surgeries but STILL I am going HOME FOR CHRISTMAS!!! CSF cultures so far have been clear! INR level when they first tested my blood level yesterday was lower than it was when tested this morning (meaning the blood thinner level has further to fall before it is in the "lovenox/bridging safe range". This med typically takes 2 days for a result to show up so what was tested out this morning was a result of what I did or didn't do that affected the Coumadin from 2 days ago.

While waiting in the ER last night Joan and I where talking about the things that are hard to decipher. I was talking about how hard it is to me to pick up on people's jokes, especially when the headaches are happening and how sarcasm usually goes over my head. There are so many things that (especially) people say that are so hard to interpret when the headaches are a little bit worse or the other symptoms have picked up! Joan (Sunday School Co-Teacher, great friend) and I while waiting in the ER last night to go up to the Neurosurgery fl where talking about figuring out sarcasm and if people are being sarcastic funny or sarcastic-hurtful. I rarely get this sort of thing and have just come to the conclusion lately when symptoms are worse I have an even harder time deciphering people's meanings when not black and white! Not a big deal but does make for some aweful funny "in my head thoughts or even questions to other people sometimes trying to figure out what something means or what someone meant! =)

Anyways, that is I think about all I know,
Will keep everyone updated,

Erica

VP shunt visible, Admitted via ER at UWHC-Surgery.

Just a quick post- Several weeks ago I had an Appt to go and get my haircut but at the almost last minute had called and cancelled it as I wasn't feeling well (headahces, ironically) and so I called the other day and went instead today (Fri). Anyways, my hairstylist today asked me while cutting my hair if I had had a shunt revision on the VP shunt recently of which I haven't and and she commented something along the lines of "oh this looks different, something is different with it". I didn't think to much about it till a little later and so I (as best I could) looked at the area and noted the shunt catheter appeared to be sticking out of incision and visible in about an inch area!
Not entirely knowing what to do (my brilliance) I posted on fb asking if others have experienced this which a few commented asking if I was sure it wasn't scar tissue (very sure!) or something normal.. Dr.Bragg commented that no, it isn't normal and unfortunately she thought I needed to head to the ER. =/
Anyone who remembers last year knows this is particularly disappointing bc her and I spent last Christmas with me under her care due to the shunt infection and the virtual entire month of Dec. in-patient!
Needless, I finished up at the store and called my Dad after talking to Dr.Bragg's Secretary (who Dr.Bragg had already talked to) and headed back to my Apt to pack a bag. My Co-Sunday School Teacher was meeting me at my Apt to get the supplies I had for our group-Sunday School (Christmas) meeting which after our lesson, having to do w the nativity scene we where making nativity banners w felt and dowels.

While meeting Joan at my Apt I could then give her the gifts (ornaments) we had bought for our kids. She it turns out ended up coming w me to the ER in Madison and spending from around 6-11/11:30 hanging out w/me while the ER did it's thing and we waited for a room on the Neurosurgery floor. She is AMAZING, how many friends seriously would take the time to go w a friend and spend their whole Fri night sitting in a ER?

The Neurosurgery Resident came by and did a Shunt tap (off the VP shunt) once I was in a room on the Neurosurgery fl to test for/rule out CSF infection. The Lab person did 2 blood draws to check for/rule out blood infection and the Nurses are coming back in a bit to access the Port in order to start IV antibiotics. The plan is to let the INR level trend down over the next few days and then do surgery I guess to replace or revise the VP shunt. I am not entirely sure what the plan is yet and won't know for sure I don't think till Dr.Bragg comes by (I assume) in the morning. I just pray I am healed and out of here by the time she goes on vacation!! I don't think she will do the Thoracic Peritoneal shunt while I am in-patient this time both b/c she doesn't like to mix 2 different areas/surgeries in one and then not know for sure what worked and 2. I imagine she will want to wait and do the TP shunt as scheduled in Jan.-I am more than ok with not doing both right now!

1. The part of the VP shunt cathether that is visible.
2, 3. Joan and I goofing around w 'balloon' gloves' (see the sign)

Tomorrow my Mom, Sister and I had planned to decorate our Christmas cookies (late this year) so it seems it will be another Christmas not doing this. Last year my Mom brought the frosting (she makes homemade) and the sprinkles to my hospital room along w cleaning supplies (to clean before we decorated) and then we went ahead and did it anyways. I am hoping maybe we will do something like that again this year? Guess tomorrow will tell!
I will update when I know anything more.

Hopefully the CSF and blood labs come back clear and hopefully this surgery whenever it is goes well and as well we are able to get INR back up to a therapeutic level fairly quickly post-surgery!

As disappointed as I am to be back here, spending it seems Christmas here again ( =/ ) I do know God has a greater purpose and so I have to put my trust and Faith in him!
Thanks for stopping by,
Erica

Cardiology-Holter monitor, Headaches suck

I talked to the Cardiology NP today (Weds night) and again this morning (Thurs) and they are doing a 24 hr Holter monitor (a continuous EKG) along w the EKG (remember the post I wrote a few wks ago saying I didn't think we'd have to do either of these things!? Remind me to shut my mouth in the future!) ;)
Dr.E (Cardiologist) will take this monitor results to the EP (heart rhythm) dr. then.
The recently increased Bisoprolol dose didn't do much to slow heart rate down so Dr.Earing's thought or plan was to make a new medication recommendation, likely from what Nancy (the NP) said a different beta blocker. They likely will call early next week with the Holter results and new med recommendation.
The EKG was fine and heart rhythm was normal (not exactly un-expected since it is a 6second snapshot out of a 24 hr day!) but the NP did say Dr.E was at least happy in that brief period my Heart rate (HR) was in the high 70's an improvement from immediately post both heart surgeries (July, Sept) where heart rate was high 170's, then high 120's while still in-patient and has ranged in the 80's-90's to low 100's (125 typical highest I think) since the last few months minus a few longer-higher periods.

Even when HR is running along at a faster clip I don't stop and take my pulse to see how fast it is as it doesn't change anything so those are just measurements from Cardiology Appts and from at ERT (infusion). HR overall doesn't get a whole lot faster or slower when at Cardiac Rehab.

---

I turn the Holter monitor back in tomorrow afternoon. The reasoning as I explained in the update after the Cardiology Appt a few weeks ago behind Cardiologist wanting a slower heart rate is so the heart has more time between each heart beat and thus (if I am remembering right) the heart gets more time to rest between each beat and isn't working as hard.
This week has been another chaotic week of appts betweem Monday and Weds being in Menomonee Falls for Cardiac Rehab, Tues at ERT (CHW), today also at CHW for the EKG and Holter hook-up and then tomorrow is Pain Mngmt (normal) Fup followed by dropping off the completed Holter at CHW. Friday I am getting my hair cut and that is it besides actually getting normal errands done!

Sometimes I think (seriously) that a hand drill and a straw would make a better shunt than does the current shunts I have. I mean don't get me wrong the 2 shunts I have worked reasonably well actually for about 6 mo (as a whole) and even though they weren't perfect it was still better than almost any other shunt system i'd had in the past. The past week and especially the past few days though has been quite aweful and I feel aweful-with mornings being the worst by far.
Not only do I have trouble falling asleep (getting comfortable) but then when I do wake up in the morning I am tired and I feel as if I have a ton of bricks inside my head. This isn't a new issue it has been a common refrain over the past years especially for anyone who reads this frequently!
Anyways I really think someone in the medical community ought to come up with a hand drill patients could use to drain their own fluid when our shunts are being imperfect and we have to wait for surgery for other reasons (holidays, family preferences (I don't think people have a clue how this feels), etc. I don't wish to be in-patient over the holidays either as I really enjoy all the traditions we have (baking/decorating cookies, shopping, making decorations w my nephew, decorating and wrapping the presents I find (I love wrapping presents), etc. Sunday School and our Christmas-Group Party, being with my fellow SS Teachers, and so much more. I do wish though there was a way to improve how I feel as I literally spend atleast 1/2 the day, sometimes much more than that feeling as if "I got run over be a reindeer".
Aaagghhh I HATE shunts-actually mores specifically as imperfect as they are I am grateful for shunts, I HATE hydrocephalus and MPS! This time has been so weird, so all over the place ie the symptoms are my classic bad in the morning, somewhat improve as the day goes on but then some days some of the other symptoms are worse and some days a little better.
I always feel crazy though, seriously when I see people later in the day and I feel "more fine" and I am sure I look pretty fine so they have no idea what a lot of the day is really like! Not to mention you keep on keeping on w the things you have going on but sometimes looking back it is like "holy s***, did I really make it through all that!?" - Not exaggerating on that!

Anyways, next week is Christmas, I am not in the hospital this year and I have all my gifts, bought, wrapped and tagged! I love Christmas for it's true reason though, Our Savior's birth and being with Family!
Thanks for stopping by,
Merry Christmas!
Erica

Endocrine, PMR (Physical Med Rehab-Botox), Cardiology

Cardiology

The Cardiology Appt went well with nothing to big coming up (didn't really expect anything to) just a few adjustments and otherwise all current cardiac meds (Lasix, spironolactone, beta blocker) will stay the same as "you look good and are doing pretty good so I don't want to upset the apple cart right now" I believe where Dr.E's words.
Overall Heart function is at the low end of normal so they want to keep the heart rate lower than it is with Dr.Earing doubling the current beta blocker (bisoprolol, which is used commonly for CHF, BP and less commonly for rhythm) dose. If heart rate with this increase where to last longer than 10min and especially 20min stretches at a time in the 80', 90's or higher he (Cardiol.) mentioned he would probably go to a different, stronger class of meds. His reasoning for this is that he wants there to be more time in-between each heart beat for filling and relaxing (blood, oxygen I think they explained) so the heart isn't working so hard so often. His explanation for why this is was both it was an issue prior to the heart surgeries, the MPS likely factors in and the heart surgery can often cause short term damage which needs to re-wire itself. If it where to change or worsen he would add the different med class and do an EKG + have me come in sooner (I cant imagine it will) but otherwise I see them for an Echo and Fup in 3 mo. and keep them updated in-between. They also call with each INR/lab work result so while we don't see each other we also don't escape each other.
Otherwise INR was in the high-normal range so this will be re-checked the 1st week of the new year (around New Years) and their hope is it will trend down between now and then as they'd like it to really be in the 2-ish range (2.5-3.5 is ideal range). When we do have to stop the Coumadin (see below) a few days before the shunt/spine surgery in mid-Jan., if the INR level is closer to the 2's there wouldn't be as far for the range to have to fall when I would go off of Coumadin leading up to surgery and wouldn't be as much bleeding during surgery then I think. The higher the INR before I stop the Coumadin the farther it has to fall and the less likely it is to be very low leading in to surgery meaning bleeding would be worse during I guess. (did that all just sound as confusing as I think it does? No matter how many times I re-type it, it doesn't come out sounding any clearer/better!)
Because I have a newer tri-leaflet valve and no other risk factors (previous clots, a 2nd mechanical valve) I won't have to bridge with Lovenox injections apparently before this up-coming surgery (per newer ACC recommendations) which is a nice thing! Dr.Simpson my PCP had been planning on doing the lovenox (is newer recomm's) so I passed that information along to both my PCP and to Dr.Bragg. I won't complain!

Endocrine, Physical Med Rehab (Botox)
The other 2 appts besides Cardiac Rehab where Endocrine on Tues., which those labs take a few days to come back (cortisol, thyroid, other hormone levels, etc.
Yesterday I saw the new Physical Med-Rehab dr that Dr.Bragg and especially her Nurse had recommended. Dr.Caldera is also at UW and i'll see her using my secondary insurance but she agreed that cont'ing with the botox was warranted and she would con't with the areas I previously had done + may recommend doing further botox in other areas but would like to review the previous notes further.

She seemed to have a good idea of my past shunt surgery history and was aware of the heart surgeries as the reason why I had previously had to reschedule seeing her and somewhat aware of MPS affects. Because of the holidays and other things going on we opted to wait till the end of Jan to do the next round of botox injections since it was last done in June (so just a few months outside the normal 3 mo pattern I typically do). She commented if I felt it needed to be done sooner to please let her know and she would make it happen which she seems to not mind working with other providers if need be and interested in the overall picture.

The other (much sadder) news this week has been on Sunday my Dad and I went and visited my Grandpa and he was doing really well (well for Grandpa and how he has been up and down over the past 2 or so years). but then Monday he had went drastically down hill. By Tues night most of us family where at the Assisted Living home to say good bye, later Tues night Grandpa passed away.
I am both sad about losing someone who meant so much to me growing up but also I know he is in such a better place, free of the earthly pains and restored to a full and glorious body. I can't argue with that so while our earthly sorrow is great, Grandpa's heavenly gain is soooo much better!
The funeral services are Monday night, i'll likely drive up there from ERT (infusion) in Milw. One of my closest friends (from sun school, we both teach) texted me to ask for arrangement information as although she has never met my Grandpa or most of my family other than my Dad she wants to try and come to the services to offer support. I know she has to work all day so just knowing she cares means more than I can even say! I am very grateful to have such friends as she!!
On a completely different note, Sunday I am going with Church to the Seminary where there is a Christmas Concert being put on. My other Sun School Teacher (who I teach with) and I are riding together (bus) and should be nice, afterwards (or maybe it is before I am not entirely sure) the group stops to eat. I love Christmas music and especially Christian Christmas music so am looking fwd to this.
I know it may seem odd to jump from talking about the loss of my Grandpa but I feel like with the knowledge of knowing he had God's grace and forgiveness I truly do believe he is restored to a heavenly home, one in which all who believe will one day also gain and so much better than anything we could have here on earth!

God's blessings, remember in everything God does have a reason,

Thanks for stopping by,

Erica